In Italy, a study found that implementing an inter-disciplinary Fracture Liaison Service (FLS) effectively improved adherence to treatments for secondary prevention of fragility fractures, reduced health facility admission, and improved long-term survival.
Poor bone health increases the risk of fragility fracture including a hip fracture, which is devastating to the patients and a high cost to the health care system. In this study, orthogeriatric patients discharged from a high-volume trauma center after hip fracture repair were entered into a FLS or into usual care according to their preference and goals.
The results of the study found that those who chose the FLS had higher initiation rate and up to 1-year adherence to secondary prevention of fragility fracture, including vitamin D and calcium specific anti-osteoporosis drugs and complete anti-fracture therapy. Older adults belonging to FLS also showed a lower likelihood of healthcare facility admission with a longer rehospitalization- free survival than those in usual care. Although one-year incidence of falls and fractures was similar between groups, there was a lower tendency of the subjects in the FLS to be multiple fallers. The FLS group experienced a lower 1-year and 3-year mortality and a lower adjusted 5-year mortality hazard ratio.
The author Prof. Carmelinda Ruggiero notes that “The orthogeriatric FLS is an important strategy to help us manage older adults as it improves their bone health and prevents them from falling, therefore they are less likely to have a future fracture. This results in a reduced burden to the healthcare system as well as a positive longer-term health outcome for patients”.
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